Breathe Better, Sleep Better

March is National Sleep Awareness month, giving us an opportunity to examine our sleep habits. Sleep specialist Reuben Walia, MD, with Overlake's Sleep Medicine clinic, discusses the importance of nighttime slumber, how breathing issues might affect your sleep and treatments that can help you get the best rest possible.

Why is sleep important?

Sleep is important to allow our brain and bodies to recover from day-to-day functioning and events. It is necessary for our brain to reset from complex daily cognitive tasks to improve memory, learning, creativity, etc. Good sleep gives our bodies a chance to reduce stress on the cardiovascular system, restore immunity, facilitate proper metabolism and much more. 

What causes poor sleep?

Poor quality sleep can be caused by several sleep disorders such as sleep disordered breathing, restless leg syndrome, periodic limb movement disorder or parasomnias. Other causes of poor sleep include acute stress or general anxiety, poor sleep hygiene, excessive caffeine, alcohol or certain medical conditions. External environmental factors can play a role in poor quality sleep such as pets and children in the bedroom, a spouse's snoring or excessive light in the bedroom.

What is the relationship between breathing issues and sleep?

Sleep disordered breathing is a condition where “pauses” in breathing occur multiple times per hour during sleep. Most of the time, these pauses are due to obstruction of the upper airway as people reach a deeper state of sleep, known as obstructive sleep apnea (OSA). Central sleep apnea (CSA) is a condition where these pauses in breathing are due to a miscommunication with the brain and muscles responsible for breathing; however, this condition is less common. These pauses lead to a drop in blood oxygen levels at night, which will disrupt sleep and increase stress on major organ systems. 

What are the symptoms of sleep apnea?

The main symptom of obstructive sleep apnea is snoring. Other symptoms include daytime sleepiness or fatigue, episodes of gasping or choking while asleep, dry mouth or sore throat in the mornings, morning headaches and nighttime urination. Sleep apnea can contribute to trouble with attention, memory and cognitive processing. Sleep apnea can cause high blood pressure and lead to an increased risk of a heart attack, stroke and/or arrhythmia. 

How is sleep apnea treated?

Treatment for sleep apnea depends on the severity of the disorder. However, the gold standard and first-line therapy is with positive airway pressure (PAP) therapy. This is accomplished with CPAP or BiPAP devices. These devices provide positive pressure, using a mask and hose, to keep the airway from collapsing through the night. 

Another option for mild to moderate OSA is oral appliance therapy. These devices are made by a dentist and fit over your upper and lower teeth. These devices advance the lower jaw forward to increase space in the airway for better airflow during sleep.

There are surgical options to treat sleep apnea as well. 

Is sleep apnea curable?

Weight is very strongly correlated with obstructive sleep apnea. Depending on the baseline severity, significant weight loss can eliminate OSA or reduce the severity drastically. However, this is only an option in people with a high body mass index (BMI). Not all people with OSA are overweight. In some cases, upper airway surgeries may be an option to decrease OSA severity. These surgeries reduce excess soft tissue in the upper airway to increase space for improved airflow at night. 

Do other breathing issues interfere with sleep?

Asthma is a condition that may worsen at night, causing nocturnal cough, wheezing or trouble breathing. People with chronic obstructive pulmonary disease (COPD) may experience low levels of oxygen at night which can disrupt sleep. Restrictive lung disorders, such as significant obesity, abnormal curvature of the spine, or abnormal cells, tissue or fluid in or around the lungs can make breathing during sleep difficult. 

If poor sleep is a recurring issue for you, or you are concerned about breathing issues affecting your sleep, don’t hesitate to schedule an appointment with your healthcare provider for an evaluation.